Catamenial pneumothorax

It has been appropriate that this commodity or area be merged into Pneumothorax. (Discuss)

Catamenial pneumothorax is a action of collapsed lung (pneumothorax) occurring in affiliation with menstrual periods (catamenial refers to menstruation), believed to be acquired primarily by endometriosis of the pleura (the film surrounding the lung).¹

Contents 1 Classification 2 Symptoms and signs 3 Pathophysiology 4 Diagnosis 5 Treatment 6 Epidemiology 7 References 8 External links

Classification

Catamenial pneumothorax is the a lot of accepted anatomy of thoracic endometriosis syndrome, which aswell includes catamenial hemothorax, catamenial hemoptysis, catamenial hemopneumothorax and endometriosis lung nodules, as able-bodied as some aberrant presentations.

Symptoms and signs

Onset of lung collapse is beneath than 72 hours afterwards menstruation. Typically, it occurs in women age-old 30–40 years, but has been diagnosed in adolescent girls as aboriginal as 10 years of age and column menopausal women (exclusively in women of menstrual age) a lot of with a history of pelvic endometriosis.

Pathophysiology

Endometrial tissue attaches aural the thoracic cavity, basal chocolate-like cysts. Generally the parietal pleura is involved, but the lung itself, the visceral layer, the diaphragm, and added rarely the tracheobronchial tree may aswell be afflicted.² How this endometrial tissue alcove the bust charcoal enigmatic. Defects in the diaphragm, which are begin generally in afflicted individuals, could accommodate an access path,³ as could microembolization through pelvic veins ⁴.

The cysts can absolution blood; the endometrial cyst "menstruates" in the lung. Air can move in by an alien mechanism. The claret and air could could cause the lung to collapse (i.e. catamenial hemopneumothorax).⁵

Diagnosis

Diagnosis can be hinted by top ceremony ante of lung collapse in a woman of changeable age with endometriosis. CA-125 is elevated. Nowadays, video-assisted thoracoscopy is acclimated for confirmation.

Treatment

Pneumothorax is a medical emergency because it comes with astringent pain and decreased lung function. A chest tube should be amid afterwards analytic assessment. This releases the air and menstrual blood, and the lung can re-expand.

Surgery, hormonal treatments and accumulated approaches accept all been proposed, with capricious after-effects in agreement of abbreviate and continued appellation outcome.⁶ Surgical abatement of the endometrial tissue should be endeavoured during menstruation for optimal visualisation of the cyst.⁷ Pleurodesis may aswell be helpful. Menstruation and accompanying lung collapse can be suppressed with hormone therapy,⁸ like with Lupron Depot, danazol or extended aeon accumulated articulate contraceptive pills.

Epidemiology

Some sources affirmation this article represents 3-6% of pneumothorax in women.⁸ In attention of the low incidence of primary ad-lib pneumothorax (i.e. not due to surgical agony etc.) in women (about 1/100'000/year),⁸ this is a actual attenuate condition. Hence, abounding basal textbooks don't acknowledgment it, and abounding doctors accept never heard of it. However, catamenial pneumothorax is apparently under-recognised.³

References

External links

• BlebBusters.com The Ad-lib Pneumothorax Patient Network (TSPPN) 2001- 2010

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